以丙戊酸钠为基础的抗癫痫联合用药在病因不明的Lennox-Gastaut综合征患儿中的应用

Combination use of anti-epileptic drugs based on sodium valproate in the treatment of children with Lennox-Gastaut syndrome of unknown etiology

目的观察以丙戊酸钠为基础的抗癫痫联合用药在病因不明的Lennox-Gastaut综合征患儿中的应用效果。方法采用临床随机、对照的方式,选择2013年8月至2016年2月在我院诊治的病因不明的LennoxGastaut综合征患儿84例,根据随机信封抽签原则分为观察组与对照组,每组42例,对照组给予口服拉莫三嗪治疗,观察组在对照组治疗的基础上给予口服丙戊酸钠治疗,两组均观察3个月。结果观察组的总有效率高于对照组(95.2%vs.88.1%,P<0.05)。观察组的不良反应发生率低于对照组(9.5%vs.38.1%,P<0.05)。两组治疗前后组间、组内的血清FT4、TSH含量比较差异均无统计学意义(P>0.05)。治疗后,观察组的主动肌张力、被动肌张力、行为能力评分分别为12.98±0.98、7.54±0.65、7.61±0.65,明显高于对照组(10.35±0.67、7.02±0.45、6.61±0.78),差异有统计学意义(P<0.05)。结论以丙戊酸钠为基础的抗癫痫联合用药对病因不明的Lennox-Gastaut综合征患儿的甲状腺激素的表达无明显影响,可提高疗效,减少不良反应的发生,促进患儿神经行为能力的改善。

Objective To discuss the effects of combination use of anti-epileptic drugs based on sodium valproate on children with Lennox-Gastaut syndrome of unknown etiology. Methods Totally 84 children with Lennox-Gastaut syndrome of unknown etiology in our hospital from August 2013 to February 2016 were chosen by using a randomized and controlled method, and they were divided into observation group（ n = 42） and control group（ n = 42） according to random lottery envelopes. Patients in control group were treated with lamotrigine, and patients in observation group were given sodium valproate combined with lamotrigine. The efficacy was observed for 3 months. Results The total effective rate in observation group was higher than that of control group（ 95. 2% vs. 88. 1%,P 0. 05）, and the incidence of headache,drowsiness,nausea, loss of appetite and other adverse reactions was lower than that of control group（ 9. 5% vs. 38. 1%,P 0. 05）. There was no significant difference in the serum levels of FT4 and TSH before and after treatment（ P 0. 05） or between the two groups（ P 0. 05）. After treatment, the active muscle tension,passive muscle tension and behavior ability scores in observation group were higher than those of control group（ 12. 98 ±0. 98 vs. 10. 35 ± 0. 67, 7. 54 ± 0. 65 vs. 7. 02 ± 0. 45, 7. 61 ± 0. 65 vs. 6. 61 ± 0. 78,P 0. 05）. Conclusion The combination use of anti-epileptic drugs based on sodium valproate has no obvious effect on the expression of thyroid hormone of children with Lennox-Gastaut syndrome of unknown etiology, and it can improve curative effect,decrease the incidence of adverse reactions and improve the ability of neurological behavior of children.